Rapid Weaning for Emergency Situations

Emergency Weaning

Weaning in a rush most often means that you probably have not had much time to prepare emotionally for the separation. It can be a highly charged time filled with a sense of loss, and even anger at the situation that is causing the weaning.
You may have found this page because there is acute medical necessity to wean: cancer treatment that requires chemotherapy, an HIV positive diagnosis in the USA, addiction to prescription pain medications or street drugs, or complex medical treatment involving medications that transfer into breastmilk at unsafe levels (without safer substitutions for the doctor to prescribe). You may also be reading because your baby had died, or you have lost a pregnancy after about 16 weeks. In these situations you must often choose a difficult weaning process that is entirely mother-led and it may occur far before you (or your baby) is ready. There isn’t time for gradual tapering of nursing sessions, because you are counseled to immediately wean.

Herbs and Medications That May Be Helpful in Reducing Milk Production

There is significant data that some medications and herbs reduce a mother’s milk supply. Among the herbs commonly used to “dry up” a mother’s milk are:

• Peppermint  You can make a strong saturated tea and drink throughout the day. Some mothers have said that eating Altoids (a strong mint candy that contains significant amount of peppermint oil) throughout the day can aid in stopping milk production.
• Sage You can make the leaves into a tea, or add this herb as a fragrant addition to foods. Concentrated amounts of sage (such as in tinctures and teas) may not be safe for use during pregnancy. Please consult your physician, herbalist, or traditional healer for more information.
•  Jasmine flowers Crushed, and used as a poultice placed on the breast (Shrivastav 1988)
• Cabbage leaves  Chilled, and used as a cooling compress placed directly onto the breast. (Use as frequently as needed for discomfort, change leaves when wilted)

Medications that have been reported to suppress lactation may be discussed with your health care provider, but should never be taken without the guidance of a healthcare professional due to risk of side effects or medical complications. Care should be used if you think you are pregnant, and you should discuss your options over with your doctor or midwife. The following types of medications have been reported to suppress breastmilk production in mothers:

• Bromocriptine (no longer used)
• Hormonal birth control
• Psudoephedrine

Breast Engorgement

When a mother is breastfeeding her baby, milk is removed regularly and breastmilk production continues at a fast rate until the breast is full. If a mother suddenly stops nursing, her breasts will fill with milk and cause engorgement. Engorgement is usually very uncomfortable, it can make the breasts feel hot, hard, or heavy, and it is frequently reported to be a cause of pain and tenderness.

Having full breasts sends a message to the breast to stop producing milk; a full breast is necessary for milk production to slow down and stop quickly. Binding the breasts is not recommended in women trying to wean fast, and may cause health complications such as blocked ducts or mastitis. Consider wearing a supportive, non-binding bra, use a cool compress, and avoid heating pads, or things that increase the temperature of the breast.

Some mothers have reported that expressing (removing) some of their milk so that they are not painfully engorged is helpful. Removing just a little milk often reduces the discomfort from feeling too full, and it can help a mom avoid feeling really uncomfortable. With milk expression, the goal is to remove just to comfort, do not drain your breast! Remember: If you are weaning due to current drug or medication use, take to your health care provider before feeding your baby with any of your expressed milk.

Quick Comfort Measures

Cold packs, frozen peas, frozen cabbage leaf compresses, and other cool compresses on the breasts will most likely help with engorgement pain. You can remove a little milk for comfort, but do not drain the breast. You can also check to see if taking an over the counter anti-inflammatory medication is acceptable with your health care provider.

Problems with Engorgement

Occasionally some mothers experience blocked ducts or mastitis when they have been engorged for a long time. If you develop a fever over 100 degrees, your breasts are painful, you see red streaking on your breasts, or you feel a large wedge shape area that is hot to the touch, please contact your healthcare provider immediately for health counseling.

How to Feed Your Baby After Weaning

Find a bottle nipple that your baby will accept: the slower flow nipples will be an appropriate transitional speed of milk delivery, if you have been breastfeeding up until now.

If your baby refuses a bottle, consider offering cups, slow flow sippy-cups, offering milk at different temperatures or spoon feeding.

What to Feed Your Baby After Weaning

If you are eligible to receive human milk from a milk bank you will be able to offer donor breastmilk . If you have stored milk from a period of time when your milk was medication/drug-free you can use that too. If the baby is under a year old, it is recommended that you do not offer cow’s milk or other animal milks in place of human donor milk or artificial baby milk (formula). Cows milk and other animal milks do not provide the proper nutrition for an infant. Take to your healthcare provider for personalized information and recommendations regarding feeding options.

A Mother’s Feelings about Weaning

The physical sensation of very full breasts and being unable to nurse your baby or child may be very difficult. Not being able to respond in the normal fashion to your baby’s need to nurse, cuddle at your breast, or dealing with your own emotional need to connect to your child may be the hardest part of weaning quickly. As an adult you understand why weaning is happening, but a young child will most likely not understand and you will probably need the support of family or friends during this challenging time for both of you.

It is normal to feel sad, anxious, worried, to cry, to feel angry at your situation, and to feel sorrow at not being able to communicate the reasons for not breastfeeding in an understandable way with your baby/toddler. Finding another mother to speak with may be a very good way to talk through your feelings. If you are unable or unwilling to discuss the topic of your weaning with others, there are community support programs that offer free counseling to mothers in crisis. If your depression feels very strong, you are crying frequently, or you start to feel like hurting yourself or your child, please call 1-800-273-TALK or Chat http://www.suicidepreventionlifeline.org/.

There should be no shame in reaching out for help when you need it.

Moving Into a New Phase Of Mothering

As part of the cycle of life, mothers carry their unborn children, birth them, guide them and love them in childhood and beyond. It is part of a normal process for all animals to wean in their own time. For some mothers the grieving of a lost relationship must happen before any forward motion can happen. Allowing yourself time to sit with your feelings, without trying to bury them, may help you gather the strength to begin your new role as a mother that is not nursing.

The bond that is forged by breastfeeding is a strong bond. I have described it as an invisible cord that connects the two hearts of the mother and the child. If there is separation, the cord stretches easily, but it remains connected.

Once you have made it through the initial period of weaning, your child may still protest the loss of nursing. It is very common and normal for a baby or toddler to reconnect with their mother by sticking an arm down mom’s shirt, or by touching the breast for reassurance.

It may be hard to do without breastfeeding, but with time and patience you will restore your positive and healthy relationship with your child. By normalizing your experience, telling your child why things are happening in simple ways (even if they cannot understand much language yet) they will most likely feel respected and included. I do believe that all weaning, even rapid weaning can be done with compassion.

As an end note, mothers who have weaned may resume breastfeeding. If weaning is only necessary for a short period of time while you’re undergoing treatment, it may be possible to maintain your production in order to resume breastfeeding at a later time. You can read an article on that topic here: Can There Be Breastfeeding After Weaning

References:

Aljazaf, Khalidah et al. Pseudoephedrine: effects on milk production in women and estimation of infant exposure via breastmilk. Br J Clin Pharmacol. 2003 July; 56(1): 18–24 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884328/

Dettwyler, K., Ph.D. (1999). A Natural Age of Weaning. Retrieved April 21, 2012, from Katherine Dettwyler website: http://www.kathydettwyler.org/detwean.html

Riordan, J., & Wambach, K. (2010). Lactation Following Breast cancer. In Breastfeeding and Human Lactation (4th ed., pp. 316-317, 606). Mississauga, Ontario Canada: Jonesand Bartlet.

Shrivastav P, George K, Balasubramaniam N, Jasper MP, Thomas M, Kanagasabhapathy AS. Suppression of puerperal lactation using jasmine flowers (Jasminum sambac). Aust N Z J Obstet Gynaecol. 1988 Feb;28(1):68-71.

Thomson Healthcare Inc.  Bromocriptine (oral route).  2012. Micromedex, Mayo Foundation for Medical Education and Research.

(c) 2012 Serena Meyer, IBCLC. All rights reserved. Updated 10/14